Localized myxedema of the toe: a rare presentation of graves' dermopathy

Infiltrative dermopathy is an uncommon manifestation of Graves' disease. The most frequent location of infiltration is the lower extremities, especially the pretibial areas and on the dorsum of the foot. Rarely the hand, elbow, arm, and forearm are affected. We report a 66-year-old man with Graves' disease of nine years duration who presented with dermopathy and nonpitting edema of the toe with no involvement of the pretibial portion since four years ago. Radiologic studies of the foot were normal, without subperiosteal bone formation or reaction. Skin biopsy was consistent with pretibial myxedema. This presentation of myxedema and limitation to a localized area for several years is very unusual.